No abstract available.
Carcinoma, Squamous Cell ; Humans ; Osteosarcoma

No abstract available.
Epidermolysis Bullosa* ; Hand Deformities* ; Hand*

The Authors newly designed one of the Myocutaneous Falp modifying the peroneal island flap. This flap involved a part of peroneal muscle and skin on the outer side of leg and pedicle consisting of the peroneal artery and vein as an island flap. It was useful on soft tissue and skin defect of ipsilateral leg or foot region, which area was needed thicker one than simple cutaneous flap. We have treated four patients using this flap and achieved satisfactory results.
Arteries ; Foot ; Humans ; Leg ; Skin ; Veins

The Odontoid process fracture has been treated by prolonged external immobilization of by internal fixation and fusion. We reported congential and traumatic odontoid process fracture which were successfully treated by transoral fusion. Operative preparation, technique and postoperative management are described by in detail.
Immobilization ; Odontoid Process*

BACKGROUND: Diagnosing and determining the stage of lung cancer by means of positron emission tomography (PET) has been proven valuable because of the limitations of diagnosis by computed tomography (CT). We compared the efficacy of PET with that of CT in diagnosing pulmonary tumor and staging of lung cancer. MATERIAL AND METHOD: We performed F-18 FDG PET to determine the malignancy and the staging on patients who have been suspicious or were diagnosed as lung cancer by chest X-ray and CT. The findings of PET and of CT of 41 patients (male, 29; female, 12; mean age, 59) were compared with pathologic findings obtained from a mediastinoscopy and thoracotomy. RESULT: Out of 41 patients, 35 patients had malignant lesions (squamous cell carcinoma 19 cases, adenocarcinoma 14 cases, adenosquamous cell carcinoma 2 cases) and 6 patients had benign lesions. Diagnosing of lung cancer, the sensitivity, specificity and accuracy of CT and PET were the same for two method and the numbers were 100 %, 50 %, and 92.7 % respectively. Eighteen LN groups out of 108 mediastinal LN groups who recieved histologic examination proved to be malignant. Pathologic lymph node (LN) stage was N0-N1 31 cases, N2 8 cases, N3 2 cases. The correct identification of the nodal staging with CT, PET scans were 31 cases (75.6%), 28 cases (68.3%) respectively. The LN group was underestimated in each 6 cases of CT and PET. In 4 cases of CT and 7 cases of PET, they were overestimated in compare to histologic diagnosis. In the detection of mediastinal LN groups invasion, the sensitivity, specificity and accuracy of CT were 39.8 %, 93.3 %, and 84.3 % respectively. For PET, they were 61.1 %, 90.0 %, and 85.2 %. When two methods considered together (CT+PET), they were increased to 77.8 %, 93.3 %, and 90.7 % respectively. Conclusion:PET appears to be similar to CT in the diagnosis and the nodal taging of pulmonary tumor. Two tests may stage patients with lung cancer more accurately than CT alone.
Adenocarcinoma ; Diagnosis ; Electrons* ; Female ; Humans ; Lung Neoplasms* ; Lung* ; Lymph Nodes ; Mediastinoscopy ; Positron-Emission Tomography* ; Sensitivity and Specificity ; Thoracotomy ; Thorax

PURPOSE: Testicular seminomas are radiosensitive and adjuvant radiation therapy after orchiectomy results in long term survival in early stage diseases. Ten year results of radiation therapy after orchiectomy and results of definitive treatment of recurrent seminoma are presented. MATERIALS AND METHODS: Between August 1980 and February 1990, 32 patients with testicular seminomas were treated at the Department of Therapeutic Radiology, Seoul National University Hospital. Twenty-seven patients received radiation therapy after orchiectomy and 5 patients for treatment of recurrent tumors. Two of postoperatively treated patients and 2 of recurrent patients were excluded from the study because of incomplete treatment. Of the patients treated postoperatively. 18 were stage I, 5 were stage IIA, one was stage IIB, and one was stage IIC. There were 4 ipsilateral and 2 contralateral cryptorchids. Preoperatively, b-HCG levels were elevated in 5 patients. Median dose to pelvic and paraaortic lymph node area was 2900 cGy (1550-4550 cGy). One patient with stage I, 4 with stage IIA, and 1 with stage IIB received prophylactic mediastinal irradiation. Two patients were treated with chemotherapy before radiation therapy. Median follow-up period was 104(3-144) months. RESULT: Local control rates were 100% at 5 years after orchiectomy. Five year survival rates were 94.4% in Stage I and 100% in Stage II patients. One patient with stageII disease died 3 months after surgery due to mediastinal metastasis. All the 3 patients treated for recurrent disease are alive without disease. CONCLUSION: Postorchiectomy radiation to the pelvis and para-aortic area remains the treatment of choice for patient with early stage testicular seminoma. Radiation therapy is also an excellent treatment modality for recurrent seminoma.
Drug Therapy ; Follow-Up Studies ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Orchiectomy ; Pelvis ; Radiation Oncology ; Seminoma* ; Seoul ; Survival Rate

Seventy four patients with soft tissue sarcomas treated by postoperative radiotherapy in the Department of Therapeutic Radiology, Seoul National University Hospital between August 1979 and September 1990 were analyzed. The follow-up period ranged from 3 to 145 months with a median of 51 months. Liposarcoma and malignant fibrous histiocytoma(MFH) constituted 54% of the cases and the histologic grades of tumors are as follows: grad I, 23 case; grade II, 17 cases; grad III, 24 cases; unknown grade , 10 cases. The patients were treated by marginal(17 cases), wide(55 cases) or compartmental(2 cases) excision followed by postoperative radiotherapy. The total radiation doses were 4200-8820 cGy(median 6000cGy), 180-200n cGy daily, 5 times per week. Of 74 patients, 35 utimately failed. The local control was 62.2% at 5 years and cumulative rik of distant metastasis was 22.3% at 5 years. The overall survival and disease free survival were 72.3% and 53.3% at 5 years, respectively. Survival after appearance of metastasis was 15.1% at 3 yeaers. Patients with liposarcoma experienced better local control that those with other histologic type and tumor grade and surgical resection margin significantly correlated with local recurrence, distant metastasis and overall survival on univeriate analysis. In conclusion, re-excision is needed for patients with positive surgical resection margin to improve local control and further therapeutic measures using effective chemotherapy should be explored in the hope of improving overall survival.
Disease-Free Survival ; Drug Therapy ; Follow-Up Studies ; Hope ; Humans ; Liposarcoma ; Neoplasm Metastasis ; Radiation Oncology ; Radiotherapy* ; Recurrence ; Sarcoma* ; Seoul

BACKGROUND: Tumor necrosis factor(TNF) has been considered as an important candidate for cancer gene therapy based on it9 potent anti-tumor activity. However, since the efficiency of current techniques of gene transfer is not satisfactory, the majorities of current protocols is aiming the in vitro gene transfer to cancer cells and re-introducing genetically modified cancer cells to host In previous study, it was shown that TNF-sensitive cancer cells transfected with TNF-α CDNA would become highly resistant to TNF. Understanding the mechanisms of TNF-resistance in TNF-α gene transfected cancer cells would be an important step for improving the efficacy of cancer gene therapy as we]1 as for better understandings of tumor biology. This study was designed to evaluate the role of new protective protein synthesis in the acquired resistance to TNF of TNF-α gene transfected cancer cells. METHOD: We transfected TNF-α c-DNA to WEHI l64, a murine fibrosarcoma cell line, using retroviral vector (pLT12SN(TNF)) and confirm the expression of TNF with PCRf ELISA, MTT assay. Then we determined the TNF resistance of TNF gene transfected cells(WEHI 164-TNF) and the changes of TNF sensitivities after treatments with actinomycin D(transcription inhibitor) and cycloheximide(translation inhibitor). RESULTS: WEHI 164 which was sensitive to TNF became resistant to TNF after being trsnsfected with TNF-α gene and the resistance to TNF was partially reversed after treatment with actinomycin D, but not with cycloheximide. CONCLUSION: The acquired resistance to TNF after TNF-α gene transfection may be associated with synthesis of some protective proteins.
Biology ; Cell Line ; Cycloheximide ; Dactinomycin ; DNA, Complementary ; Enzyme-Linked Immunosorbent Assay ; Fibrosarcoma ; Genes, Neoplasm ; Necrosis ; Transfection ; Tumor Necrosis Factor-alpha* ; Zidovudine*

BACKGROUND: The replacement of the narrowed long-segment trachea with various prosthetic materials or tissue grafts remains a difficult and unsolved surgical problem. Homologous cryopreserved tracheal transplantation has been considered to treat the irreversibly-damaged organs, such as in the lung or heart transplantation and also to overcome the limited supply of donor organs. We examined the morphological changes and the immunosuppressive effects of the cryopreserved trachea after the heterotopic transplantation in the rats. MATERIAL AND METHOD: Sixty tracheal segments harvested from 30 donor Wistar rats were heterotopically implanted into the peritoneal cavity of 20 recipient Wistar rats and 40 Sprague Dawley rats. The 60 recipient rats were divided into 6 groups(10 rats/ group). In groups I, II, and III, 30 tracheal segments were implanted immediately after the harvesting and in groups IV, V, and VI, the segments were implanted 28 days after the cryopreservation. Groups I and IV were Wistar syngeneic controls. Groups II and V were Sprague Dawley recipients receiving no immunosuppression and Groups III and VI, were Sprague Dawley recipients receiving immunosuppressive agents. At 28 days all rats were sacrificed and the tracheal segments were evaluated grossly and histologically. RESULT: Immunosuppression of the tracheal segments had a significant influence on the changes of the tracheal lumen and tracheal epithelial cells, irrespective of the cryopreservation of the trachea(p<0.001). In groups III and VI receiving immunosuppressive agents, the tracheal lumen was patent and the normal epithelial cells were observed, however in the other groups not receiving the immunosuppressive agents, there were almost luminal obliteration by the proliferation of the fibrous tissues and a loss of the epithelial cells, the findings were similar to those in the case of obliterative bronchiolitis after a lung and a heart-lung transplantation. CONCLUSION: With the appropriate immunosuppressive agents, the lumen and the respiratory epithelium of the transplanted tracheal segment were well preserved, even after the cryopreservation of the tracheal segment, which shows the possibility of the long-term preservation and homologous transplantation of the trachea. But fibroproliferative obliteration of the tracheal lumen and the loss of the normal respiratory epithelial cells, characteristic findings of obliterative bronchiolitis, were observed in the groups without the immunosuppression. This experiment using the rat trachea may be useful in studying the pathogenesis, treatment, and prevention of obliterative bronchiolitis after a lung and a heart-lung transplantation.
Allografts ; Animals* ; Bronchiolitis Obliterans ; Bronchiolitis* ; Cryopreservation ; Epithelial Cells ; Heart Transplantation ; Heart-Lung Transplantation ; Humans ; Immunosuppression* ; Immunosuppressive Agents ; Lung ; Models, Animal* ; Peritoneal Cavity ; Phenobarbital ; Rats ; Rats, Sprague-Dawley ; Rats, Wistar ; Respiratory Mucosa ; Tissue Donors ; Trachea* ; Transplantation, Heterotopic* ; Transplantation, Homologous ; Transplants

To identify pretreatment prognostic factors in locally advanced carcinoma of the uterine cervix, retrospective analysis was undertaken of 154 patients treated with curative radiation therapy at Seoul National University Hospital, from March 1979 through December 1980. According to FIGO classification, eight patients were stage IIIA, 134 were stage IIIB, and 12 were stage IVA. Five year locoregional control rate was 58%, 51%, and 27% in stage IIIA, IIIB, and IVA, respectively. Five year disease free survival was 57%, 40%, and 25% for each stage respectively. Five year overall survival was 67%, 51%, and 33% in stage IIIA, IIIB, and IVA, respectively. In univariate analysis, fewer than or equal to four of pregnancies, initial hemoglobin of lower than 10 g%, and pelvic sidewall invasion on CT were associated with poor locoregional control. Number of pregnancies, initial hemoglobin level, obstructive uropathy on intavenous pyelography(IVP), pelvic lymph node(LN) status on CT, and pelvic sidewall Invasion on CT were significant factors in disease free survival. In terms of overall survival, pelvic sidewall invasion on CT and bladder invasion on CT were prognostically significant. In multivariate analysis, no factor was found to affect locoregional control and pelvic LN status was a sole significant factor affecting disease free survival. In terms of overall survival, the size of primary tumor was a significant prognosticator.
Cervix Uteri* ; Classification ; Disease-Free Survival ; Female ; Humans ; Multivariate Analysis ; Pregnancy ; Retrospective Studies ; Seoul ; Urinary Bladder ; Uterine Cervical Neoplasms